Latch better at full breast - help!!!!!

I would be really, truly happy if someone could explain to me what indicates if baby has better latch and better milk transfer at full/firm breast, not soft one.
This thing bugged me with son #1, and it is really causing serious problems with son #2. I did ask this question different LCs. Never got clear answer. One even told me that is "nearly impossible". And in these 3 nursing years I have encoutered another two moms who had similar observation with their babies. And both also had/have breastfeeding issues.
Can please someone clarify me this, please?

Re: Latch better at full breast - help!!!!!

Hi and welcome. So sorry you are having this difficulty. It must be frustrating to be experiencing the same problem again! Here are a few ideas, just throwing stuff out there to see if anything makes sense to you.

Is baby latching better when on the more full breast, or just getting more milk? It is not necessarily the same thing.

Milk will tend to flow out of a full breast more readily or more powerfully, so baby might well get more milk faster than when nursing with a softer breast. Also with a fuller breast and more powerful flow, a baby might not have to have as good a latch and still get plenty of milk. This is why sometimes latch issues (such as tongue tie) are not discovered until months later when milk production naturally calms down and a mom is not as full and baby starts not gaining well- not because there is not enough milk but because now baby cannot get the milk out well.

I have read that when a baby has a cleft lip or palate, nursing on a fuller breast allows them to get a more effective "seal" when they latch, giving them a better latch and better milk transfer. To my mind, if a fuller breast sometimes helps babies in those situations latch better, it makes sense that babies with less severe but still significant latch problems might also find a fuller breast helpful in getting a better seal.

Also breast anatomy and how it changes might impact latch. Generally babies (especially newborns) latch best if they have a nice firm nipple to latch onto. If the moms nipples tend to be more flaccid when she is less full and more erect when she is full, then that might impact latch.

When your LCs observed you and baby nursing and performed before and after nursing weight checks that showed poor intake with a softer breast, what was their explanation for lower milk intake?

Re: Latch better at full breast - help!!!!!

I think it is actually both. Better latch and better milk removal. Seal is much better at full breast. Less air swallowing. Baby is more content after feeding at full breast. I remember how my first son was shocked after my breasts became soft. He chewed on them. But eventually he learned to extract milk.
With second one I do not know where to start with our problems. He has mild laryngomalacia, did tongue frenectomy without any success, he can nurse in sleep, but when awake he will pull few times on breast and give up. Even if my milk starts dripping, he will not go back to breast. He is 5.5m old now, and it has been like this from his 7th week. The only thing similar between him and his brother is that both have/had moderate tongue tie and my memories of beautiful breastfeeding on full & firm breast (I was never engorged).
We did two ent examinations and few LC consultations without success. During first two months no one even payed attention to my complaints since son #2 got 1700g and 1000g during his first two months.
I am on borderline to quit. It is not that he screams near my breast. It is that either he is totally uninterested for nursing or too much agitated to calm down and nurse. His mindset is just to difficult to handle.

Re: Latch better at full breast - help!!!!!

I am sorry things are so frustrating. Without way more info I cannot begin to guess why your baby is not very interested in nursing/cannot get a good seal/latch. Since you have already seen LCs you are probably not interested in seeing another, however I would suggest that if it is possible you might want to think about it, especially if it has been a while since your last consult. Sometimes the problems causing breastfeeding issues do not become clear until several months down the line. Breast disinterest at this age usually has something to do with how and/or how much a baby has been supplemented, but not always. Has baby ever had any trouble feeding with bottles?

since son #2 got 1700g and 1000g during his first two months.

I assume this is daily intake? Does this mean you were measuring intake all day? Is this because gain was poor, or nursing hurt? I am trying to understand what alerted you to a problem in the first place. This amount of intake is of course normal to high daily intake. So if this was happening I am not surprised a problem was missed.

If you are ready to try a different feeding method than breastfeeding, I would suggest not thinking of it as quitting. Just because for many, this word has a negative connotation that is not appropriate for such a situation. I have found that when parenting issues arise, a responsive parent will try one thing, and if it does not work, or only works for a while, or is too much effort for too little reward, or for whatever reason not working out, then you try something else. Too long parents have been told that parenting is a one size fits all thing, with hard and fast rules that you will screw up your kid if you don't follow. But this is not true. Parenting involves at a minimum the needs, wants, quirks, personalities etc. of two human beings and often more. This means every situation is entirely unique with its own set of joys and frustrations.

When it comes to breastfeeding, specifically, to make an informed decision, biological realities must be considered. The reality is that if a lactating woman stops removing milk from her breasts, her body will respond by ramping down and eventually stopping milk production. This process will always happen with no effort- Less milk removal = less milk production. Sometimes milk production can be "brought back" but only with a very high degree of effort and even then it is not always possible. So when it comes to breastfeeding, the decision to no longer nurse and/or no longer pump or hand express does have what we can reasonably assume will be a permanent consequence of greatly reducing or ending milk production. So, that is a reality that must be acknowledged if you are going to make an informed choice. But there are many choices we make as parents that close one door or another. So (IMO) that still does not mean that it is appropriate to call no longer breastfeeding "quitting."

Re: Latch better at full breast - help!!!!!

I do not know where to start or end describing everything that happened for the last few months with my other son.
First seven days after birth everything has been ideal. He latched witout problems, was content baby who was either sleeping or nursing. He started to gain weight 2nd day after delivery.
After 6 or 7 days I noticed that he is becoming more difficult to settle down when totally awake. At the same time his stridor was more apparent and he started to choke more and more on my milk flow. We went to ped. She said it is my too fast flow. Fast forward he was diagnosed for mild laryngomalacia which also caused significant reflux. Since he was gaining really good (1st month 1700g, 2nd month 1000g) no meds were given to him.
However I did started to notice in those first two months his latch is becoming more shallow and that many times he starts nursing but rarely finishes breast.
Gradually for the next two months he nursed less and less awake. It was almost impossible to get him to breast without first putting him to sleep or comforting him with letting him suck on my pinky finger (for so many many minutes every single day) and then latching. At some times he was too unsettled and wa awake for several hours, rigid and agitated (I am quite sure he was in pain from reflux). At those times only way we could get some milk in him was by fingerfeeding. And that kind of situation lasted for two months.
When he was 4.5m old his tongue tie was revised due to seal breaking, air gulping, lack of suck/swallow/breathe coordination. No improvement. Still he nursed only when asleep. Since it was painful procedure for him, and I felt really guilty about whole thing (despite it was actually LC that never warned us that it is going to be so painful) I started to give bottles between his naps (Lansinoh with slow flow nipple). I have to say I was a bit relieved then. At least he was getting some milk between his naps and I could stop worry so much how much he is hungry.
He is 5.5m old now. I have been trying to get him back on breast again when awake. But it is so hard. I do not think his primary reason for refusal is bottle as much all previous negative associations with breastfeeding due to laryngomalacia amd reflux. He behaves so unsettled near breast. Plus he is really active baby. Despite babywearing, coosleeping, me being top off most of the time, he has zero interest in breast when awake.
And since he is sleeping less and less, which means he nurses less and less, I feel my supply going down.
I do not know what I am dealing with: breast aversion, nursing strike, breast refusal....? And how to get him into state of mind where breast is his "zen" place.

Re: Latch better at full breast - help!!!!!

In particular I find it interesting that again, mom is reporting fast letdown that baby is having a problem with, and then baby starts nursing only or mostly when asleep. Also of course a baby who cannot latch/control milk flow properly is likely to have more issues with fast letdown than a baby who does not have any problem with latch. So I am wondering how much this is all connected.

One thought I keep having is that we know how important baby habitually nursing for comfort is, when it comes to nursing longevity. This is one reason why pacifier overuse causes breastfeeding issues. Other culprits that interfere with baby forming a comfort nursing habit are the various limits moms are so often told to place on nursing...like timing sessions, meal scheduling, sleep training, not letting a baby nurse to sleep, etc.

So, in a case where latch issues, reflux pain (how is that going now?) and forceful letdown were a concern early on, could that have prevented baby adopting a comfort nursing habit?

Anyway, as far as I know, no matter what is the source of the issue, and whether it is breast aversion, nursing strike, breast refusal or something else, the basics for addressing the issue should you wish (or wish to keep trying) are the same. You have likely read this article, https://kellymom.com/ages/newborn/nb...ack-to-breast/ It is the only one I know of that covers this subject so thoroughly. Unfortunately sometimes the same things have to be tried again and again.

Also if baby is being fed much with bottles, another factor that sometimes develops is that baby is not motivated to nurse all that well or often because they are just not hungry! (This does not mean it is helpful to make a baby very hungry to get them back to the breast, usually that backfires, but to some degree with older and healthy, well fed babies that approach may help.) But overall it is just important to be careful about overfeeding- generally or at a single meal.

Re: Latch better at full breast - help!!!!!

My son stopped comfort nursing very very early, first week after delivery. I remember that I felt he wants to nurse for comfort but all that milk constantly coming out was bugging him.
I am quite sure we did not overfeed him. His weight gain after initial first two month was 500g per month. Yes, sometimes we did fussed about eating, but it was during those days when he would refuse to nurse for several hours. And bottles were introduced last month. He drinks from bottle usually 30-60mL between his naps and it takes forever that he drinks even that small amount. Although, I did notice for the last 7 days that he is developing "fondness" toward bottle. And that made me panic.
So I am back to spoon feeding but it is messy and his diapers are not so full since he can't get so much milk like with bottle or breast.
I have read before post you indicated about vicious circle of nursing in sleep and not nursing when awake. After reading it I did try to skip nursing him during his shorter naps to encourage nursing while awake (I just carried him in ssc during his sleep). Result was catastrophic. He had only one wet diaper whole morning and early afternoon.
And it is hard to keep my supply with this kind of regime.

Re: Latch better at full breast - help!!!!!

Thanks to this conversation and kelly mom article, I managed to sort out my toughts a little.
At this point situation is like this: when I offer breast, if he takes it (50% times), he sucks few times and let it go.
I tried pumping prior offering to elicit let down or dripping some milk on my nipple. No big change. Sns system also does not work. Especially now when he is older and grabs tubes.
To me it seems that he does not want or know how to make effort to go through whole feeding. Or is afraid of flow.
The trouble is next: he can cope with flow best in side lying position. But when awake I can hardly get him in that position.
Sometimes he will nurse longer in ssc or sling to the point of getting let down. Despite him being vertical and above my breast he still can not cope with flow. I do not think I have OP at this moment. But I also wonder is my flow still too much for him due to laryngomalacia. If I stop pumping my supply would probably decrease and flow would be probably easier for him. But I am afraid of going to the other side of spectrum- low milk supply. Should I try to stop pumping and see what will happen?
And my guess is that during his first two month, when I had so much milk, he learned just to hang there at the breast and milk will come without any effort.
So, any ideas how to teach/encourage him to just put a bit more effort into nursing when awake? Holding him hungry will not do trick. It just makes him anxious and then he will not take breast at all.

Re: Latch better at full breast - help!!!!!

I tried as kelly mom described latching with the help of syringe (letting milk flow towards nipple slowly). He took breast numerous times and let it go. He will just not suck more than 3-4 times. He is so agitated at the breast. Today one LC told me if he can manage breastfeeding in sleep, he can when awake. And that I should cut with bottles and it is matter of time when he will realise it is breast or nothing.
Today I tried for 2h to get him to actually nurse hopping him will eventualltly take it, start to nurse and fall asleep. At one point I had too hungry and overtired baby. So I gave him bottle.
I do not understand. For so many months I have been trying to soothe him before nursing with sucking on my pinky finger. Carry in sling, walking, singing, everything I can think about. And still he is agitated at the breast.
Is it just me or he just does not like breast. It is one thing to make baby to eat from breast in order to survive. It is another to make him like it.
Am I thinking wrong?????